There are only choices. Those choices have type one (alpha)
or type two (beta) errors. The first is an erroneous rejection of the null
hypothesis—accepting significance when none exists. A type two error occurs
when the null hypothesis is erroneously retained—missing a significance that is
present. When making any decision, especially one where the data informing the
decision are inadequate for certainty to rule, you are always prone to these
errors. Your decision is based on whether you wish to have your decision favor
a type one or a type two error. In the end, it’s about regrets.

The decision with the coronavirus was a stark one. Should
the country, state, county or city over which some leader had authority close
down its economy to protect the health of the citizens? If you do it, and the
threat turns out to not have been significant you are basically saying the null
hypothesis was not in play and that you will favor being wrong that way—a type
one error. If you kept everything open, you are basically risking that the null
hypothesis (correlating the risk of the virus via open commerce to your
constituents) was retained erroneously. You get the idea. There is no way to be
certain so you are betting on your being wrong one way or the other. Most of
the world bet that the threat from the coronavirus was so great as to
necessitate the closing of virtually all commerce, a tanking of the major
markets, and the upheaval of the health care systems.

Most every leader, seeing the devastation in China and Italy
elected to reject the null hypothesis (this is not significant or significant
enough to close down the economy) and risk a type one error. Was that the right
call? I don’t know yet, but I do know it was the safe call. Better many people should
lose money than many people lose their lives. If that was the trade off, which
it appears to have been. But, it is not the number who died from covid-19 that
is the issue. It is the number who died of covid-19 who would not have died of
something else (influenza, cancer, etc.) AND comparing that with how many died
because of the closure of the economy and life as we knew it? It all has to be
considered and can only be considered in retrospect.

This blog is just a plea to understand that is what
happened. I have friends that would have chosen the other alternative. Would
that have led to the apocalypse? We shall never know. What we may know when
this is all said and done is:

With truly widespread testing of antibody levels, how
many Americans contracted the virus? This assumes many of the infected were not
ill. What if most of the infected were not ill?

Of those, how many became symptomatic? If this is a small
percent of the total infected, herd immunity may already be operational or the
virus is not serious in most people.

Of those infected and symptomatic, how many were
hospitalized?

Of those, how many died?

Can we explain those who fall into category 3 and 4?

When the data come in, we will know
whether the gamble on the “safe” alternative was the wise one and precisely how
much it cost. This is very important because it is unlikely that this will be
the last such global medical challenge and we need to learn how soon we could
have known what the right decision was. As of now, we do not.

I have been wrestling with myself, my
family and many friends trying to imagine what I would have done had the
decision been mine in any of the jurisdictions in which these tough calls had
to be made. I know I would not have shut down all research or elective surgery at
MD Anderson. I would have found a way to let the most vital of investigations
stay alive and given optimal care to cancer patients.

If it turns out that Governor Cuomo
really does need 30,000 ventilators, he will have looked like a genius in
predicting the course of the plague and how to get ready for the next one.

By contrast, if a robust economy falls
backward to a significant degree and the number of total deaths from covid-19
are no more than what one might see in a bad flu year, well, we may have made
the wrong call.

This is just a plea to understand that
is what has been going on for the past few weeks and months. Yes, had China
been more forthcoming, we might all have been more ready. Yes, had Mr. Trump
paid more attention to some of his own advisors, he would have been better
prepared to weather this storm and he would have stopped saying silly things at
his news conferences and let the people who know actually talk. This scourge
was all predicted by his own people back in October and by the Obama
Administration almost three years ago. Why wasn’t the federal government ready?

It’s all about choices. Everyone makes
them except when the government steps in and makes the choice for you. In the
end, the voters ought to hold the leaders responsible for these decisions. Type
one and Type two errors are all there are in life. You make the call when you
get married, buy a house or pick a college. There are always choices. They can
be wrong. You do get to pick which wrong way is the most likely. That’s all you
get to pick.